Douglas Vakoch, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20394 Issued in CA

Practice address

2041 Bancroft Way Ste 202
Berkeley, CA 94704-1443

Phone

(510) 612-0097

Fax

(510) 768-8111

NPI assigned

Jun 6, 2019

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Green Psychotherapy, PC

  • Clinical Psychologist
  • Berkeley, CA
  • NPI 1366001034
  NPD Authorized official
• Meti International

  • Voluntary or Charitable Agency
  • Berkeley, CA
  • NPI 1770123325
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1689233355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 CHERRY WAY",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945411836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 BANCROFT WAY STE 202",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041443",
            "telephone_number": "510-612-0097",
            "fax_number": "510-768-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2940 Summit St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946093416",
            "country_code": "US",
            "telephone_number": "510-612-0097",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "815 Hyde St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941095996",
            "country_code": "US",
            "telephone_number": "510-612-0097",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1918 Bonita Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947041014",
            "country_code": "US",
            "telephone_number": "510-612-0097",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3867 Howe St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946115343",
            "country_code": "US",
            "telephone_number": "510-612-0097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAKOCH",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-06",
        "last_updated": "2023-11-27",
        "certification_date": "2020-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "20394",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "20394",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "20394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.greenpsychotherapy.com/contact",
            "affiliation": "Y",
            "address_1": "1918 Bonita Ave",
            "city": "Berkeley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "947041014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shoshana Uribe, L.AC.
• Nakako Uritani, DDS
• Brittany Louise Usinger
• Keith Uyemura, OD
• Bhavana Vadrevu
• Melissa Ann Valdellon, O.D.
• Eti Andrew Valdez-Kaminsky, MFT
• Heather Valdez, LCSW
• Diana Ibarra Valencia
• Blanca Estella Valentine, RN, NP, CNS

• Clinical Psychologist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.